Provider Demographics
NPI:1073637609
Name:BEDRY FAMILY CHIROPRACTIC INC PS
Entity Type:Organization
Organization Name:BEDRY FAMILY CHIROPRACTIC INC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:D
Authorized Official - Last Name:BEDRY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-647-0954
Mailing Address - Street 1:1842 IRON ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4646
Mailing Address - Country:US
Mailing Address - Phone:360-647-0954
Mailing Address - Fax:360-647-8711
Practice Address - Street 1:1842 IRON ST
Practice Address - Street 2:SUITE B
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4646
Practice Address - Country:US
Practice Address - Phone:360-647-0954
Practice Address - Fax:360-647-8711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002372111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA70884OtherL & I